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Open Journal of Nursing, 2017, 7, 524-547 http://www.scirp.org/journal/ojn
ISSN Online: 2162-5344 ISSN Print: 2162-5336
DOI: 10.4236/ojn.2017.75041 May 19, 2017
Meanings Given to Professional Care: Focus Group Results
Mary Kalfoss*, Jenny Owe Cand Scient
Diakonova University College, Oslo, Norway
Abstract Background: Many studies have focused on exploring the concept of care from patient and nurse perspectives, but knowledge is limited regarding stu-dent perceptions. Objective: To explore the meanings given to the concept of professional care from the perspective of graduate students in nursing and pastoral care. Research design: A qualitative study was employed with the formation of six focus groups. Data were analyzed via a thematic content analysis of the discussions. Participants and research context: Thirty-one students attending a University College in Oslo participated. Findings: Seven main themes and forty-four subthemes were identified. Major themes in-cluded reverence and respect for the dignity and value of human life, bonding, sensitive to self and other, communication, competence, willfulness and deep caring. Discussion: Different levels of intentionality, professional comport-ment and caring consciousness were revealed in the discussions. Findings also lend support to major beliefs and values in Watsons Human Caring Theory. Conclusion: The focus groups generated valuable detail of complex expe-riences behind students perceptions, attitudes, beliefs and actions. Focus group methodology can enhance holistic nursing practice by providing op-portunities to explore and clarify holistic care values, create opportunities for self-awareness and transformative learning in education, clinical practice, administration and research.
Keywords Caring, Concept, Focus Groups, Nursing, Pastoral Counseling
Thoughts about care today have coalesced into an ethical theory with the power to evaluate personal relationships, professional conduct, public policy, interna-tional relationships and global issues . The concept of care/caring is also the
How to cite this paper: Kalfoss, M. and Owe, J. (2017) Meanings Given to Profes-sional Care: Focus Group Results. Open Journal of Nursing, 7, 524-547. https://doi.org/10.4236/ojn.2017.75041 Received: April 24, 2017 Accepted: May 16, 2017 Published: May 19, 2017 Copyright 2017 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/
M. Kalfoss, J. Owe
essence of many caring disciplines and is not exclusively a phenomenon that be-longs to the nursing discipline  . However, as evidenced by practice and research, nursing has a long legacy as a caring-healing profession and many claim that caring is an integral part of nursing    . Further, caring is also emphasized by nursing researchers -.
Because caring is a core value in nursing practice, the capacity to care is a de-sired attribute in nursing students. Likewise, others have discussed the need for caring to be translated and transmitted in the practices of nursing education . Caring has also been cited by many authors as the core value of nurse edu-cator-student relationship. Nurturing a caring attitude in nursing education and in the educator relationship is especially important as this is the students first confrontation with the significant values and essence of their profession . Despite carings fundamental place in professional care, education and practice, researchers and scholars have not reached a common definition to transmit to students. This has resulted in a wide array of various interpretations regarding the meanings of professional care, often leading to confusing and contrasting views amongst students, teachers, health professionals and patients. Because post-modern nursing care has become the focus of economical, technological and political and social restraining forces, the need to provide holistic quality care in the contemporary health care system has become urgent together with the importance of cultivating caring in nursing education . Because a critical task of nursing educators is to promote students learning about caring, it is im-perative to explore students perspectives about the meanings they give to the concept of professional care.
1.1. Literature Review
Focus Group Studies on Perceptions of Care/Caring The focus group has gained considerable popularity as a means of gathering
qualitative data in nursing research over the past 20 years   . Focus groups interviews are carefully planned discussions, designed to obtain percep-tions on a defined area of interest  and are reported to be one of the most acceptable methods for obtaining research information on subjective percep-tions . Most authors agree that the main advantage of the focus group inter-view is the purposeful use of interaction in order to generate data . Merton identifies 3 major components of focus group research as: 1) a method devoted to data collection; 2) interaction as a source of data; and 3) the active role of the researcher in creating group discussion for data collection. Focus groups are particularly suited to capture everyday knowledge from the terms and language people use to give meaning to their everyday world. Focus group interviews have also been shown to contribute to a body of knowledge that is conceptual and theoretical . Schroeder and Neil  argued that focus groups are specifical-ly useful for investigating issues in nursing in relation to caring.
Others have also explored the concept of care/caring from a student perspec-tive using focus groups and participant observation. Dobrowolska and col-
M. Kalfoss, J. Owe
leagues  explored how nursing and medical students understood care in their first practicum, and how their views changed over time. Results showed that both medical and nursing students defined care in the same way with themes consisting of compassion, commitment, competence, confidence, con-science, communication, patience, courage and support. Nursing students viewed their caring to be within both practical and emotional dimensions and this was a core feature of their identity as nurses. Medical students, on the other hand, viewed the practical dimension of care as an additional activity. All the students in the study underlined the importance of having time to care and showed that, for them, time in this context was embedded in moral meaning.
Sapountzi-Krepia and colleagues  conducted focus groups with Greek nursing students exploring their perceptions regarding the concept of care and found that care was related to care as an emotional order, care as a service, care as bodily and psychological support, care of an individual or group, and care as a constant phenomenon. In this study, perceptions of care also in-cluded the aspect of love. MacNeil and Evans  studied the concept of care in nursing education from the perspective of students. In this study, students were asked to describe moments of caring experienced in the educational setting. Themes identified included connectedness, support, presence, respect and pro-motion/support of personal growth. Karaoz  investigated last year under-graduate students perception of caring. Students were asked to write incidents in which they observed nursing behavior conducted in caring and uncaring ways, followed by interviews. Professional/helping and relational/technical com- petencies were the major themes discussed.
Although not based upon focus group methodology, Papastavrou and col-leagues  in a large survey with surgical patients and their nurses found that both patients and nurses perceived knowledge and skill as being the most im-portant caring behaviors. However, they found differences in the importance of human presencing and respectful deference to others, whereas nurses perceived such behavior as being more important than the patients. In a recent study, Be-gum and Slavin  also explored perceptions of caring in nursing education of Pakistani nursing students by personal interviews and found that caring represented a mothering relationship, helping attitude, limit setting, communi-cation, and a source of empowerment and development.
Lastly, in another study focused on the aspect of learning caring, Ma and col-leagues  explored baccalaureate nursing students perspective on learning about caring in Chinese focus groups. Results demonstrated four themes which included learning by positive role models as an ideal way of learning about car-ing, negative role models as another way of learning, lack of directive substance as a hindrance to learning care, and lack of cultural competence as a barrier to learning about caring. In sum, many of the findings in these studies varied in re-lation to meanings given to care and caring behaviors.
Based on focus group methodology, the aim of this study was to explore the
M. Kalfoss, J. Owe
meanings given to professional care by Norwegian nursing and pastoral students enrolled in post graduate classes in order to increase the body of knowledge re-garding care, based on research evidence.
1.3. Theoretical Framework
Transpersonal caring relationship The theoretical framework for this study is based on Watsons Human Caring
Theory which emphasizes caring as a transpersonal caring relationship. F